Today, the National Health Commission issued a notice on the "Novel Coronavirus Pneumonia Prevention and Control Plan". A reporter from the Beijing News noted that this is another important adjustment to the epidemic prevention-related plan after the update of my country’s new co

Today, National Health Commission issued a notice on the "Novel Coronavirus Pneumonia Prevention and Control Plan (Ninth Edition)".

A reporter from the Beijing News noted that this is another important adjustment to the epidemic prevention-related plan after the update of my country’s new coronavirus diagnosis and treatment plan in March this year.

Wu Hao, leader of the National Health Commission’s Community Prevention and Control Expert Group on COVID-19 and dean of the School of General Medicine and Continuing Education at Capital Medical University, said that since December last year, we have begun to face the challenge of the spread of the Omicron virus. , in more than half a year, my understanding of it has deepened. Based on the characteristics of the Omicron mutant strain, which has a short incubation period, rapid spread, and strong concealment, various aspects such as the setting of the isolation period, the delineation and management of risk areas, and nucleic acid antigen detection have been revised to form this version of prevention and control plan.

He also said that as the new coronavirus and epidemic situations change in the future, the prevention and control plan will be dynamically optimized and adjusted. We must not only prevent the epidemic, but also minimize the impact on production and life.

html On June 27, in Jilin City, Jilin Province, "Dabai" was conducting nucleic acid testing for residents. Picture/IC photo

Focus 1: Shorten the close-contact quarantine period and cancel the sub-intensive quarantine

As Omicron replaces the previous new crown mutant strain as the main epidemic strain, based on its characteristics, whether the isolation duration of relevant risk personnel should be adjusted is determined by the industry extensive attention.

Wang Liping, a researcher at the Transmission Prevention and Control Division of the Chinese Center for Disease Control and Prevention, introduced that from March to May 2022, the Comprehensive Team of the Joint Prevention and Control Mechanism of the State Council carried out pilot research on the optimization of COVID-19 epidemic prevention and control measures in selected areas across the country. The study found that mysterious The average incubation period of Kron mutant strains is shortened, mostly 2-4 days; most of them can be detected within 7 days. The incubation period of the

virus is an important basis for setting the isolation duration. The reporter noticed that with the shortening of the incubation period of Omicron, some areas had previously tried to adjust the isolation period. In May this year, Beijing announced that close contacts will be subject to "10 days of centralized quarantine + 7 days of home quarantine", sub-close contacts will be subject to "7 days of home quarantine", and high-risk groups will be subject to "10 days of home quarantine + 7 days of health monitoring". Compression during the isolation period. The national prevention and control plan announced by

today unified and clarified the isolation management of risk personnel.

The isolation and control time for close contacts and immigrants has been adjusted from "14 days of centralized isolation medical observation + 7 days of home health monitoring" to "7 days of centralized isolation medical observation + 3 days of home health monitoring", and the overall time has been shortened by about half. . The nucleic acid testing measures were adjusted from "nucleic acid testing on the 1st, 4th, 7th, and 14th days of centralized isolation medical observation, collecting nasopharyngeal swabs, and double sampling and testing before lifting the isolation" to "centralized isolation medical observation on the 1st, 2nd, 3rd, and 5th day" , 7-day and nucleic acid testing on the third day of home health monitoring, and collect oropharyngeal swabs ". Dual collection and testing are not required before the centralized isolation medical observation is lifted.

For the management of secondary density, the "7-day centralized isolation medical observation" has been canceled and adjusted to "7-day home isolation medical observation", with nucleic acid testing on the 1st, 4th and 7th days.

"Shortening the isolation period can reduce the work pressure at the isolation point and effectively utilize isolation resources. It can also help those who have been eliminated to return to normal life as soon as possible and relieve their psychological pressure." Wu Hao said.

html On June 28, in Dongguan, Guangdong, some towns and streets carried out regional nucleic acid testing, and medical staff were taking samples for citizens. Photo by Xin Qing/IC photo

Focus 2: A 48-hour nucleic acid negative certificate is required to leave a low-risk area

Wu Hao introduced that previously, the delineation of risk areas was based on risk analysis and judgment based on the number of local confirmed cases and the number of clustered epidemics. Control areas , closed and controlled areas are measures of prevention and control response, and the two are independent concepts. In the new version of the prevention and control plan, the two are integrated, the two types of risk area delineation standards and prevention and control measures are connected and corresponding, and the concept of medium and high risk areas is uniformly used to form a new risk area delineation and management and control plan.

For high-risk areas, the area is closed and 24-hour patrols are arranged. Management can be strengthened by installing monitoring equipment, electronic door magnets, etc. to prevent people from going out and strictly staying at home.If a high-risk area is located at the junction of urban and rural areas or in rural areas, where sanitary conditions are insufficient, management is difficult, and there is a high risk of transmission, residents in the area can be transferred to centralized isolation facilities (if necessary, no more than one person per household can be kept) .

If new infections are discovered during the lockdown period, the local joint prevention and control mechanism will organize a risk assessment and follow the requirements of "one district, one policy" to extend the lockdown period in whole or in part of the original lockdown area. If there are no new infections for 7 consecutive days, and all personnel in the risk area complete a round of nucleic acid screening negative on the 7th day, it will be reduced to a medium-risk area; after that, if there are no new infections for 3 consecutive days, it will be reduced to a low-risk area.

"The so-called one district, one policy means that if there are new cases in the risk area, it does not necessarily need to extend the lockdown period of the entire area. It can make more precise distinctions to avoid one person being infected and everyone being 'accompanied'." Wu Hao explained However, this also tests the risk analysis and management capabilities of various places, especially in large communities, which must emphasize grid-based refined management.

In addition, the plan also stipulates that when carrying out nucleic acid testing in high-risk areas, the route must be scientifically determined to prevent from cross-infecting . Buildings and courtyards where positive infected persons have been found can undergo antigen testing first, and then conduct nucleic acid testing in an orderly manner after negative results. Wu Hao believes that increasing antigen testing can further improve screening efficiency and reduce the intensity of sampling work for grassroots prevention and control personnel, allowing them to have more energy for community protection. At the same time, citizens should consciously and standardized testing, and be responsible for themselves and their families.

Medium-risk areas implement control measures, during which "people are not allowed to leave the area and items are picked up at staggered peak times." If there are no new infections for 7 consecutive days, and all persons in the risk area complete a round of nucleic acid screening negative on the 7th day, they will be reduced to a low-risk area.

Other areas in the county (city, district, banner) where the medium and high risk areas are located are low risk areas. Implement prevention and control measures of "personal protection and avoid gatherings", and a 48-hour negative nucleic acid test certificate is required when leaving the city.

After all medium and high-risk areas are lifted, normalized prevention and control measures will be implemented throughout the county (city, district, and banner). In other areas, people with a history of traveling to low-risk areas in the past seven days are required to complete two nucleic acid tests within three days.

html On February 20, at the Taicang New Area exit of Shenhai Expressway in Taicang, Jiangsu, traffic and public security law enforcement officers were verifying the information of passing vehicles and personnel. Picture/IC photo

Focus 3: "Negative" is not the hard standard for discharge. How to connect with community control?

In the latest version of the new coronavirus diagnosis and treatment plan, one of the most watched revisions is to lower the discharge threshold and no longer use nucleic acid negative as a hard standard.

According to the diagnosis and treatment plan, the Ct values ​​of N gene and ORF gene in two consecutive novel coronavirus nucleic acid tests are both ≥35 ( fluorescence quantitative PCR method, the limit value is 40, and the sampling time is at least 24 hours apart), or two consecutive novel coronavirus nucleic acid tests have Those who test negative for nucleic acid (fluorescence quantitative PCR method, the limit value is less than 35, and the sampling time is at least 24 hours apart) and meet the corresponding standards such as body temperature, respiratory symptoms, imaging , etc. can be discharged from the hospital (released from isolation).

So, what should be done if the nucleic acid test is positive after discharge? The new version of

prevention and control guidelines has classified regulations.

Among them, after a previously infected person is discharged from the hospital (cabin), if the nucleic acid test of the respiratory specimen is positive, if there are no symptoms or signs and the nucleic acid test Ct value is ≥35, management and close contacts will no longer be determined; if the nucleic acid test Ct value is <35,>

If clinical manifestations such as fever and cough occur, or CT imaging shows worsening of lung lesions, they should be immediately transferred to a designated medical institution for classified management and treatment according to the condition. If the Ct value of the nucleic acid test is ≥35, there is no need to track and control their close contacts; if the Ct value of the nucleic acid test is <35,>html On March 19, Changchun, Jilin, the first batch of 21 new coronavirus pneumonia patients in Changchun City, which was affected by the Jilin epidemic, were cured and discharged. Photo by Su Nuo/IC photo

Focus 4: How to carry out regional nucleic acid screening? Plan clear standards

Due to the rapid spread and strong concealment of Omicron, various regions have taken different measures to deal with mutant strains this year. Among them, regional nucleic acid screening has been widely used. The new version of the

prevention and control plan clarifies the frequency of regional nucleic acid screening based on differences in city size.

In provincial capital cities and cities with a population of more than 10 million, after the outbreak of the epidemic, it is determined through flow surveys that the chain of transmission is unclear, there are many risk places and people at risk, and the mobility of risk people is high, and there is a risk of the epidemic spreading. Carry out a nucleic acid test for all employees. After three consecutive nucleic acid tests show no social-wide infection, another nucleic acid test for all employees will be carried out three days apart. After there are no social-wide infections, nucleic acid testing for all employees can be carried out.

In other areas where infected people move frequently and stay for a long time, a certain area can be designated to carry out nucleic acid testing for all employees based on flow surveys. In principle, nucleic acid testing of all employees will be carried out once a day. If there is no social infection in three consecutive nucleic acid tests, nucleic acid testing of all employees can be carried out. In the event of widespread community transmission across regions, the command will be escalated, and the provincial joint epidemic prevention and control mechanism will decide whether to carry out nucleic acid testing for all employees in the city.

After an epidemic occurs in a general city, if it is determined through current surveys that the chain of transmission is unclear, there are many risk places and people at risk, and the movement of risk people is high, and there is a risk of the epidemic spreading, the urban area of ​​the city where the epidemic is located will conduct a daily nucleic acid test for all employees. , after three consecutive nucleic acid tests show no community-wide infection, a nucleic acid test for all employees will be carried out three days apart. If there is no community-wide infection, nucleic acid testing for all employees can be carried out.

Areas outside urban areas will be designated to carry out nucleic acid testing for all employees based on flow surveys and judgments. In principle, nucleic acid testing of all employees will be carried out once a day. If there is no social infection in three consecutive nucleic acid tests, nucleic acid testing of all employees can be carried out.

In rural areas, after the outbreak of the epidemic, according to the current investigation and judgment, the transmission chain is unclear, there are many risk places and risk people, and the risk personnel are highly mobile. When there is a risk of the epidemic spreading, the natural villages affected by the epidemic, the seat of the township government and the county where it is located , carry out a nucleic acid test for all employees every day. After 3 consecutive nucleic acid tests show no social-wide infection, another nucleic acid test for all employees will be carried out 3 days apart. People with no social-wide infection can undergo nucleic acid testing for all employees.

When the epidemic spread to multiple towns and villages, based on epidemic research and judgment, nucleic acid testing was expanded to all employees. In principle, nucleic acid testing of all employees will be carried out once a day. If there is no social infection in three consecutive nucleic acid tests, nucleic acid testing of all employees can be carried out.

Beijing News reporter Dai Xuan

editor Chen Jing proofreader Li Lijun